Tag Archives: Jeremy Hunt

October 5, 2015 · 11:25

How to cure economic sickness

The Guardian is bringing me grim news today. As a British conservative and as an Australian Liberal the news presented does not look good, it is slightly beyond critical. It also reminds me of a small gag I heard in the Netherlands 3 decades ago. The one-liner was: “Due to a death, this cemetery will remain closed for the next few days” (source Fons Jansen), yes it seems like a laughing matter, but the Grimness behind it is less amusing and more dread based than we realise. The news ‘Ministers ‘are hiding details of £2bn NHS cash crisis’‘ (at http://www.theguardian.com/society/2015/oct/03/ministers-hiding-details-nhs-cash-crisis) is at the centre of all this. As a conservative my response (with all due respect) to Prime Minister David Cameron is ‘Sir, are you barking mad?‘ I will direct this at the Prime Minister because he is ‘our’ leader, the man in charge. If there is even the slightest hint that he was not aware than a massive reshuffle will be needed within the next 48 hours.

You see, I have forever opposed hiding bad news. Managing bad news will always bite the parties involved in the end. When the implied deficit amounts to 0.5% of all collected taxations in 2014, we have a massive problem which must be addressed and it needs to be addressed sooner rather than later. You see, no matter how trivial this 0.5% might seem. The coffers are down well over a trillion pounds, which requires 100% of all collected taxations for three years to address. Now that act is not realistic, but that show you the massive damage the United Kingdom faces. Economies are slowing down, partially due to Asia, partially due to acts that America is about to do and as such the American economy will soon take another tumble. As I see it, Thanksgiving and Christmas might hide the events, but the end of January through March, especially when the US Department of Defence will make 40,000 people redundant, that economy will shift over the following 4 months. In all this, the UK can no longer afford to hide bad news of this nature. The Commonwealth in general needs to realise that as the US seems to enable greed based corporations, we as members of the Commonwealth will have to stick together. This is no longer about national pride and ego. Our collective politicians are more likely to walk away with opportunities that will guarantee the well-being of their families for more than two generations, whilst in all this the people will end up getting saddled with a debt that will stop them from moving forward in any decent future for decades to come. None of us agreed to such imbalance.

The quote “Heidi Alexander, the shadow health secretary, said on Saturday: “This appears to be a cynical attempt to suppress bad news ahead of the Tory party conference. It makes a mockery of Tory claims to be committed to transparency in the NHS, and leaves Jeremy Hunt with very serious questions to answer. These figures must now be published in full as a matter of urgency”” gives weight to this. Part of me is also very cautious on her statement, let’s not forget that it was Labour that squandered 11 billion from the NHS and they have not been forthcoming at all, so let’s realise that this still remains an issue of the Pot calling the Kettle black.

The next part is set over two quotes. The first is “Professor Chris Ham, chief executive of the King’s Fund think tank, recently said that the NHS’s fast-ballooning deficit was leading to “panic” at the health department and “denial” at the Treasury. The service’s overspend was so large that it needed an emergency injection of £1bn in the comprehensive spending review to keep functioning, added Ham“, the second quote is “Without extra funding, he argued, the NHS would end up unable to cope, “most likely during the winter when many hospitals run out of money … With NHS hospitals unable to go bankrupt…, the Treasury will be forced to intervene or accept a rapid decline in performance.”“. The issue is in more than one part. In the first we must question how the NHS ended up short by 2 billion. We have heard all the wild accusations in the papers, but what news there has any reliability? No matter how little of it is true, Jeremy Hunt has an official problem, because if he has kept facts away from the public than he has no right being in his position, if he is falling on his sword for the party, we have an even larger issue. Because the conservative members feel that they should be told the facts, good or bad. We cannot fix when things remain hidden. We within the Commonwealth will become puppets to those operating the machines. It is a fake freedom which does do no one any good.

Yet the NHS has issues on several levels. One level was discussed in my blog article called ‘In Greed we trust‘ (at https://lawlordtobe.com/2015/09/22/in-greed-we-trust/). Here we looked at Turing Pharmaceuticals AG and the little caper they pulled on Daraprim. They weren’t the only ones. The Financial Post (at http://business.financialpost.com/investing/global-investor/valeant-pharmaceuticals-international-inc-shares-plummet-as-525-hike-in-drug-price-draws-fire) gave us “Valeant Pharmaceuticals International Inc. shares fell as much as 20 per cent after Democrats in the U.S. House asked to subpoena the company for documents relating to drug price increases, the latest move by politicians seeking to curb price hikes on acquired drugs“. When we see places like Turing Pharmaceuticals ‘hiding’ behind places like PrWeb and PrNewsWire, you better believe you are facing marketing from the bottom of the barrel. Yet in all this serious demands from the government looking into these companies who bought up niche medications and driving up prices by hundreds of percentage points is a matter this government (as well as the previous one) did not have to content with and as such the NHS will receive even more pressure. This is exactly why I have pushed for close to two years towards a stronger Commonwealth coalition. India with its Generic pharmaceuticals that will become one of the pillars of salvation for the NHS. This needs to happen now, before the Australian government (as well as the previous one) does something irreversibly stupid like signing the TPP. We must recognise here that it was not Australian Labor or the Australian Liberals asking the questions that had to be asked, it was New Zealand that put up a fight against the TPP issues. So have we been watching a media event by Martin Shkreli and Turing Pharmaceuticals?

Because we all need to realise clearly that once the TPP is signed, the signing government will have placed a knife on the throats of nearly 21.7% of the population of Australia, whilst that group will be left with no medical alternative!

That part reflects on the NHS!

When we consider some information from the ABPI (at http://www.abpi.org.uk/our-work/library/industry/Documents/OHE%20ABPI%20Medicines%20Bill%20Forecast.pdf), we must also acknowledge that they, the Association of the British Pharmaceutical Industry, represents commercial enterprises, a branch not to favoured, or flavoured towards generic medication. They are given, as I personally see it (read: speculate) the inside track from ‘friends’ on how far they must lower the price to remain seated. It is a form of let’s say branded exploitation that can no longer be afforded. Now, we must be clear that there is nothing illegal on branded exploitation, but we have to acknowledge that the NHS can no longer afford to play that game (a 2 billion deficit is ample proof of that).

Within the ABPI we see plenty of information, now consider this one quote from one of their presentations: “Loss of exclusivity of some major brands is projected to yield £3.4bn cumulative savings to the NHS between 2012 and 2015 with £5.4bn cumulative lost revenue to industry“. Do you think this is about the savings to the NHS, or the revenue lost to industry? If you think that this is about ‘savings to the NHS‘ than you, the respectful reader, will be slightly too naive than is good for you! I cannot fault the ABPI, because it is doing what it needs to do, represent its industry, we all forgot that they are not living in a symbiotic relationship with the government as they provide THEIR solutions to the NHS. The people the ABPI is representing, is a commercial group. They want to get the most out of whatever they can. Culling their needs by having stronger ties with Generic brands, even Indian ones is essential. They might cry about their low prices, but the reality is different. These players claiming the high costs are hoping you forget about news from 2001 (and many other years) where we saw “The UK government is introducing tax incentives aimed at persuading British-based pharmaceutical companies to boost their research into diseases affecting the world’s poor, such as AIDS, tuberculosis and malaria“, so they get the tax breaks for research, they have the inside tracks on ‘maximising’ product pricing solutions, yet overall they still complain. Which in light when we consider the ABPI document showing a 15% growth in spending on medication to be another issue. This is was a projection over 4 years (up to 2015), yet the facts remain, the NHS needs another solution and we agree that generic medication will not be as strong, however a medication that needs to be taken 10% longer might be preferable to medication that is 30% more expensive. Clarity is what matters here and for the implied accusation that Jeremy Hunt was keeping people in the dark should be offensive to all of us. There is one more side to all this, which is shown in that same presentation. The Office of Health Economics (OHE) is stating with their key message 6 that: “By 2015, new branded medicines launched between 2012 and 2015 will account for less than 2% of the total medicines bill. This underlies the issue in the UK of slow uptake of innovative new medicines“. From an analyst side I want to offer this thought to you. the quote ‘new branded medicines’ implies not that they are new medication, but new versions of existing medications, which means that rebranded and possibly marketed solutions is now implied to be below 2%, yet whatever deal is in place, it could also imply that this 2% is also a group that for now cannot be replaced by generic mediation. This is a speculation on my side, yet these kinds of presentations are never about ‘informing’ the people, it is about awareness on which questions to ask and what solutions to push for. Both tend to be expensive exercises for any NHS.

Yet medication is only one side, it is the one side we can clearly fight for with the possible reward of direct savings, but other sides need to be considered too. This we see in the comment article in the Guardian called ‘This junior doctor contract puts patients in danger‘ (at http://www.theguardian.com/commentisfree/2015/oct/04/junior-doctor-contract-patients-danger). Can anyone explain to me how the stupidity of “The contract that the Department of Health is threatening to impose on junior doctors once again raises the prospect of 90-hour weeks being written into rotas“? I went to University with some of these upcoming doctors, the pressure on them is just beyond harsh. How can a 90-hour contract be allowed? apart from that being a step just one hair fraction away from being regarded as slave labour, the pressures on these people will result in a certain harm to them self, an implied certain harm to their patients and a long term harm to the NHS as a whole. Because this will fall over within 2 years after which there will be no doctors left, there will be nearly no nurses left and the UK gets to rely on the medical care we can import from Siberia and Africa, how would that end well?

As a final year student in Intellectual Property law I call upon my peers to aid the NHS, give aid to them by creating strong patents for Generic medication, for patents that  lessen the stranglehold on prolonged exclusive medication. In 2008 in the Financial Times, Yusuf Hamied, stated: “I am not against patents, but India cannot afford them. I am against monopolies”, he is correct! In addition, now 7 years later the UK and many other nations cannot afford them either. That part has been ignored on many governmental levels all over the Commonwealth. The response the article gives: “he is a “pirate”, an opportunist who has exploited others’ intellectual property to swell his own profits. In the process, they say, he is undermining investment in future medicines, including the next generation of HIV therapies“, this fake response is flame baked with emotion, the reference to ‘the next generation of HIV therapies‘ does that. You see they had a patent, they had exclusivity for 20 years, but the people in that house became lazy and greedy and now they do not want to give it up. They try to revamp the drug to the tiniest part (they will call it an innovative new drug) and then they reshape it with a patent for 20 more years of exclusivity. They are now learning that this is not always successful. As a Patent Attorney (if I make it to the end) I would want to work on the patents of Generic medications, lowering the barricades to NHS on a global level, which is one of the reasons I oppose the TPP. Governments (including the UK) have squandered the position they had by prolonging a solution that never worked and voila, here we have the trillion pound deficit!

OK, I admit it is not a completely accurate statement and as such the issues are more complex, but we must fight the wars we can win and the NHS war could be won, however if Mr not so bright, I am hiding the numbers Jeremy Hunt MP is indeed hiding the numbers, any NHS solution will come too late, which puts 68 million in peril.

I feel that I am on the right track. Some will question my view towards Generic Medication Patents. When I consider my duties as stated in the Code of Conduct for Patent and Trade Marks Attorneys 2013, I see section 11 that a registered attorney must act as a patent attorney or a trade marks attorney in the following:

  • In accordance with the law; and
  • In the best interests of the registered attorney’s client; and
  • In the public interest; and
  • In the interests of the registered attorney’s profession as a whole.

The first two would carry for certain, the latter two are the debate. I believe that Generic Medication and protecting these is in the public interest on a global scale, I never believed that ‘reworking’ a patent, unless it is truly a new substance was in the public interest. You see exclusivity is a right given to the actual innovator, not giving in perpetuity, which only propagates exploitation, the last part is that the profession as a whole relies not on the cash of the rich client. It relies on driving true innovation, when we start repackaging the same solution with a new delivery method (which costs less than $15 dollars to make), the price hike from $20 to $175 is not just a tough pill to swallow it is a dangerous escalation in our greying population. The fact that Patent Laws as well as Patent Regulations have not been properly updated (even though this example is specifically for the US, not the UK) should give warning to other parts that needs to be overhauled.

This all hits back to the NHS. The Independent showed a few sides which reflects mighty badly on Jeremy Hunt. You see the quote: “it was his intention that no one should lose out financially” might sound nice and perhaps the change to a schedule where doctors work 7 days a week might not be an avoidable part, yet in all this the 90 hour a week part is still one of the deadliest issues. That person might not feel a financial ‘pinch’, but I guarantee you that these hours will drive most doctors bonkers within 2 years. How can the NHS survive when by 2018 23% of the medical GP’s are in a sanatorium? Did Mr Hunt add that risk to his spreadsheet?

So how will this end? Well, for Jeremy Hun MP not all that good I reckon (speculation on my side), but we have to wait to see all the facts to place judgment on this. In all this, as I see it, I started with the title: ‘How to cure economic sickness‘.

The answer in my case is by changing direction, by changing it massively. There is now more than half a decade of data and Business Intelligence that the US only considers the US and there they falter and fail as they refuse to deal with Greed. They hide behind more and more emotional stories (especially when there are school shootings), even there the US legislative branch is failing its people. The Commonwealth cannot afford these steps. We the Commonwealth must unite as never before. We the people of the Commonwealth must also realise that to make this work we must be willing to make large changes if needed. I always lived a global live, so if I am required to move to the UK, Canada or perhaps even India, than I will! In this day and age, holding onto your one little hill (especially those with tertiary educations) we must consider a global (read a complete Commonwealth field). The UK must start to realise this too, because they have squandered too much funds on solutions that never worked. Australia is moving into that direction as well as Canada, they just move in that direction more politely than the other players.

And finally my message to David Cameron. David, your Conservative party can be the solution, we all can be part of that solution, yet in all this we must know how bad things are and the playbook you currently use needs to change, the US can no longer be seen as a potential ‘solution’, they burned that bridge by themselves. Our Commonwealth can grow towards the empire it was, we have the skills, we have the innovators, we have the drive and (most of us) the loyalty to the crown, yet in all this, not enough drive towards a Commonwealth Union has been made. The SNP is partially evidence of that. They now realise that their oil revenue is not making it work, they need to realise that together we are stronger. Yes, perhaps that will be as an independent Scotland, but then it should still be a Commonwealth Nation, we must propel on all sides to show both the US and China that the UK is the 5th largest economy, yet as a United Commonwealth we can surpass China and become the second largest economy! The next 12 years will be about the innovators that propel ideas in many fields. We will see a growth in Trade Marks, in Patents and in Business solutions and all this will be resulting in new avenues of growth, yet as a single nation the UK can no longer compete to the extent it needs to. The costs are too high, the NHS is the first and clearest piece of evidence.

So economic sickness can be cured, it needs the right medication and this can be administered by acquiring the right medication, the current providers have shown that they are not up to the task!

I leave it to the honourable David Cameron to set the right course!

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September 24, 2015 · 22:06

Imperitos idiot

This is a view I have had for a while, it is a view that I have advocated on more than one situation, yet business remains silent, deaf and as they hide in ignorance they are limiting the options they have, in the future and in an acted decimation of one’s own future. The information in the Guardian (at http://www.theguardian.com/us-news/2015/sep/23/us-intelligence-services-surveillance-privacy) shows a title ‘Facebook case may force European firms to change data storage practices‘ that questions certain elements. The quote “a court accused America’s intelligence services of conducting “mass, indiscriminate surveillance”” in the first paragraph is the act of alerting, but is that all?

The Case C‑362/14 Maximillian Schrems v Data Protection Commissioner is the calling entity here. A request for a preliminary ruling.

Let’s take a look at the elements. We see at [25] Mr Schrems lodged a complaint with the Commissioner on 25 June 2013, claiming, in essence, that the law and practices of the United States offer no real protection of the data kept in the United States against State surveillance. That was said to follow from the revelations made by Edward Snowden from May 2013 concerning the activities of the United States intelligence services, in particular those of the National Security Agency (‘the NSA’).

[35] Nevertheless, according to the High Court, the revelations made by Edward Snowden demonstrated a significant over-reach on the part of the NSA and other similar agencies. While the Foreign Intelligence Surveillance Court (‘the FISC’), which operates under the Foreign Intelligence Surveillance Act of 1978, (18) exercises supervisory jurisdiction, proceedings before that court take place in secret and are ex parte. In addition, apart from the fact that decisions relating to access to personal data are taken on the basis of United States law, citizens of the Union have no effective right to be heard on the question of the surveillance and interception of their data.

This all goes back to ‘the revelations made by Edward Snowden‘. I have forever had issues with the ‘revelations’, too many holes, too many issues that from an IT perspective are a given no no. In addition, it assumes a level of ‘openness’ within the alphabet group that does not exist. Such openness has never existed, yet the press and many others have been very willing to blindly accept the events of Edwards Snowden, yet the data was never made bare, the data is filtered and was largely ‘stamped’ as complex, as too dangerous. Yet proper analyses of the data was never made by any person that could be regarded as trustworthy. For now, to underline what comes, I will give you this quote “An intelligence operation is the process by which governments, military groups, businesses, and other organizations systematically collect and evaluate information for the purpose of discovering the capabilities and intentions of their rivals. With such information, or intelligence, an organization can both protect itself from its adversaries and exploit its adversaries’ weaknesses“, the source is not important right now, the impact will be discussed, yet before I do this I want to continue the other elements I started.

Now consider [224] where we see “In addition, the Commission expressly acknowledged at the hearing that, under Decision 2000/520, as currently applied, there is no guarantee that the right of citizens of the Union to protection of their data will be ensured. However, in the Commission’s submission, that finding is not such as to render that decision invalid. While the Commission agrees with the statement that it must act when faced with new circumstances, it maintains that it has taken appropriate and proportionate measures by entering into negotiations with the United States in order to reform the safe harbour scheme“.

Now consider the following thought by transforming the quote: ‘there is no guarantee that the right of citizens of the Union to protection of their data will be ensured‘ into ‘it will be certain that the right of citizens of the Union to protection of their data will be unsuccessful‘. The issue is that moving data will open up a massive amount of dangers, data instabilities and data security hazards. Too many players within the EEC and other places all want their fingers on the data so that they can get a foothold of power. It is THAT simple in my opinion!

All these nations wanting access to data, setting up corporations, all trying to make a quick buck whilst during political manipulating, the security of our data will be available to anyone offering 39 pieces of silver. Before you start listening to people with nice PowerPoint presentations and long winded explanations with considerable non liability asterisks on how this is so not possible consider the following events (at http://www.informationisbeautiful.net/visualizations/worlds-biggest-data-breaches-hacks/). Ashley Maddison might be the most sensual one, but also the most embarrassing. In that same light we can see 145 million records of EBay, Sony, Heartland with 130 million and that list goes on for a long time. So the last thing I want to see is our data in the hands of some ‘seemingly’ ignorant individual, whilst completely unexpectedly and totally against ‘protocol’ the data will make it into the hands of third parties. Now I go back to that other quote, which I will paraphrase: “An intelligence operation is the process by which businesses systematically collect and evaluate information for the purpose of discovering the capabilities and intentions of their rivals and exploit the weakness of its adversaries“. This is what I foresee. This is why the crying over the NSA, whilst handing over health data to parties too unprepared to properly protect that data is more than just a big farce. Now we need to look at two sources. The first is the Guardian on the 28th February 2014 (at http://www.theguardian.com/society/2014/feb/28/nhs-data-will-not-be-sold-insurance-companies-jeremy-hunt), which gives us “Health secretary to provide assurance that confidential information will not be used for commercial insurance“, now Wired three days before that reported (at http://www.wired.co.uk/news/archive/2014-02/25/insurance-companies-buy-medical-records) “Details relating to hospital admissions from 1989 to 2010 were given (for an extraction fee) to the Institute and Faculty of Actuaries. The 13 years of data covering 47 million patients were given to the professional body to help them ‘improve accuracy in pricing’ of insurance“, yet all insurance is commercial, so as data goes, it is out there and too many players want a slice of that pie. Forcing more personal data into any open direction is beyond dangerous. That part can be constructed from http://www.wsj.com/articles/more-health-care-insurers-seek-big-premium-increases-1433206078. “Blue Cross and Blue Shield of Illinois is looking to raise rates by averages of 29% or more. In Pennsylvania, Highmark Health Insurance Co. is asking for 30%, according to proposals submitted by insurers for the year ahead. Around the country, some of the main market leaders are looking for double digit increases“. What do you think in all honesty will happen when they get the option to make healthcare unaffordable to all or unaffordable to some. Data will become the compromise and that danger is a lot larger when it is in the hands of ‘other’ third parties whilst the law is unable to deal with the issues at hand. The US has some strict rules in place that barring national security cannot be broken. Now we see a push towards fields where these levels of security do not stringently exist. What do you expect will happen? And healthcare is not the biggest slice of it all, just the most visible one.

In all this there are issues on both sides, yet at the core the pushed fear for governmental access is a fake and an illusionary one and it is shouted the loudest by people who have a little too much to hide. Hiding for the sake of their ego, their acts and/or the need for continue or renewed satisfaction of greed. Yes, I agree that my view is polarised to some extent, I agree that my view has flaws, but I approach it from a clinical side, whilst the others are all hiding through the shouting and claims set behind the emotions, the push to fear.

In all this I have yet to see the cold light of evidence that the alphabet group is disserving the people. The link to movies and conspiracy theories, nearly all of those claimants with their own agenda, sometimes badly hidden. Yet, in that light, is my view not too conspiracy theory set? I ask that of myself too, because without that consideration it is just a viewpoint. It will remain a viewpoint no matter what, yet consider that when you seek ‘NSA transgressions’ you find very little acceptable news events, with this I mean events that are of a decent level of report. When we look at data transgressions from other parties, that list is growing at an almost exponential rate and the size of the transgressions seems to be increasing, shifting data all over the place is not my first idea of safety.

Is it your choice?

When you decide and it goes wrong, you only have yourself to blame and as I see it, you lose all rights to complain when (not if) it goes wrong.

The next iteration of our lifestyles that what happens over the next 2 generations will all be about data and who has control over it and who gets access to it, which is not freedom.

 

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June 3, 2015 · 19:18

Dr Temp MD

It did not take too long for things to get outspoken, the elections are gone, Greece is against the wall making all kinds of claims regarding Blackmail and creditors and the NHS issues are also waking up. Actually, it is the Health Secretary that is waking up. Actually, that is a little too unkind. Jeremy Hunt was not asleep, let’s just state that the elections slowed issues until the ‘after’ election moment. That moment is now!

I have kept my eye on the NHS issues that play. The NHS IT, which partially collapsed the NHS due to 11.2 billion under labour, which impacted all sides of the NHS, yet it is not all political, the NHS has many sides that do need addressing. It was not their fault, I am not laying blame here, but the pressure that the NHS gets from binge drinking must stop!

If we go by the BBC (at http://www.bbc.com/news/health-32418122), we might see that a detox centre is saving millions, which sounds nice in theory, yet the problem is not the saved millions, it is the £3.8bn a year that is a concern, a worry and the NHS can no longer afford it. So we can go two ways, we can shift the problem with drunk tanks like in ‘the good old days‘, which suits me just fine, and if you have enough money to pay for private treatment, that that is fine too, yet here we see a debatable injustice, should the rich be non-accountable? Do we approach this from a ‘if you can afford it, fine!‘ which amounts to the same. When we see statistics that 1 in 3 for A&E is alcohol related, than there is a clear issue, if there is the additional pressure that the weekend gives up to 70% of the cases which are alcohol based, we have an issue.

There are of course other means, three strikes in the weekend and your academic options are forfeit, it is an option, but will it actually make a difference? The article also has a worrying side, the quote “as much as 50% of the patients [that we see], were not open to any services and some of them had never been seen by alcohol services before“, in that quote Dr Chris Daly is illustrating that the drinking population is changing, which makes for an uncomfortable truth, is it truly alcoholism, or escapism from austerity and bad economy? It makes all the difference, but the NHS is still getting hit, so it is time to seek alternative solutions, but where to go? You see, many solutions is about shifting blame and responsibility. In my case it is about shifting responsibility and in my view, the responsibility is given to he/she who drinks! They get the bill or go into the drunk tank. My view has not unique, I did not know this last year when I championed the idea, it seems that in 2013, the Association of Chief Police Officers (ACPO for short) coined that same idea, those who get thrown in are fined and that pays for the upkeep. The ACPO is now getting replaced by the NPCC (National Police Chiefs’ Council).

I know that there are issues and it is not the best solution, but in a perfect world, the large corporations would not be ‘screwing over’ the nations it is draining of income and as such, the tax coffers could have paid for it all, but that is not the case at present. When a trillion in commerce is taxed at less than 1%, any government comes up short and that is exactly where the UK is now and changes, drastic ones will need to be made. If the pressure of 1,000,000 patients goes away, staff will be under less pressure, £3,500 per shift doctors become less on an issue, which saves additional coin and the NHS can than better be reassessed. The problems of the NHS will not be gone, but the £2Bn gap it faced as was stated on the BBC in June 2014 would suddenly drop to almost zero. How is that for a good idea? Now if we can find a few options for generic medicine by cooperating stronger with India and the NHS will suddenly show signs of life again. Now, there is every chance that people will object. They will mention that there are medical risks and I agree, but guess what, the ‘adult’ who thought he could quickly have 15 pints was supposed to be an adult, now he/she gets to see the consequence of this choice. Should the patient ‘pass away’ than we could also see a drop in rental pressure, which helps more people, and possibly another job opens up, lowering unemployment rates further. Now, if you think that this is over the top, than I will not disagree, but my side states, ‘well, stop them from binge drinking!’ It might seem hard, but dying solves everything!

Hey, that could make for a nice health care advertisement.

The doctor walks into the waiting room, states “I apologise, your … passed away”, “I have a cousin who is very interested in the apartment, and we gave his job details to our janitor, he thought it was a cool job, I heard he starts on Monday!”

Then it fades out and we see the slogan “Alcohol kills!” and under it we see “your apartment and job were filled quite quickly! Only your mother/spouse will possibly miss you”, is that not a killer advertisement?

No, it is not! But it seems that being soft around this subject is not solving anything either, that part has been proven for some time now. I think I know what you will state next. ‘It will be about the alcoholics and their mental health!’ This could be valid, yet some studies show that binge drinking is for over 70% associated with the premise that it is ‘really fun’. Most doctors and nurses disagree and they are NOT laughing!

So, even though I feel that it is not fair on the population at large, the NHS can no longer facilitate any of it. There is a small shimmer of hope, consider that the drunk tank comes with a £150 fee to get out, that invoice should be scary enough, because there will be no more money for food, rent and a few other things, which will reset the focus of such a person. Perhaps once is all they need to get a grip on the consequences, apart from looking like ‘road kill’ and smell like nothing anyone want to be next to, so that person will hopefully sober up, has to walk home and will have no other options for a little while. I personally am not convinced it would work, but if the binge drinking group is lowered by a mere 5%, we would see massive savings, deep into the millions, which opens up the debate, is it worth the risk? I would say: “look at Greece, inaction has now pretty much made them slaves to the creditors for the next 5 generations”, as binge drinking is self-inflicted, I would go for the yes vote, but in all this there is another side, how are they able to get into the binge drinking habit? There are a few options that comes to mind, but this is not about binge drinking, this is about the NHS.

Alcoholism and drugs are only a few factors, the NHS has a massive problem which for one part was addressed in the article.

We now get to the issue that is hard to oppose (but I will try). The quote “Dr Mark Porter, chairman of the British Medical Association, said the NHS’s greater reliance on agency staff “is a sign of stress on the system and the result of poor workforce planning by government”“. Is that entirely true? I think that there is a hidden non-mentioned fact here. The NHS stresses have been an issue for a longer time and yes, there are issues, but let’s go over all this. Simon Stevens is the government CEO now (that title never stops making me chuckle), before that it was David Nicholson and before that it was Lord Nigel Crisp. I want to step over all the scandals as they are just getting in the way of the issues. You see, the entire chuckling bit is an issue. It is hilarious to see a political appointed CEO, I personally believe that it is a recipe for disaster with a 100% chance of leaving a sour taste in the mouth, one way or another! It needs to get a more commercial appointment with a new board, a board of executive advisors, one political, one financial and a few medical advisors. It would be great if the CEO is a medic, but the UK is short of them already, pushing them to a governing desk is not really a solution, which of course is a little shoulder thump to Dr Mark Porter (with the friendliest intention). Of course, the quote by Shadow minister Andy Burnham is equally entertaining “mistakes by the Conservatives had led to the expanded use of agency staff“, which sounds a little over the top as the staff issues would be resolved by an IT overhaul, which Labour fumbled whilst spending over 11 billion, so that solution did not pan out and now, the conservatives are still fixing the mess. In addition, the statistics show a sheer increase of costs. In the term of Labour 1997 – 2010, the costs for the NHS doubled. The earlier mentioned IT failure being a chunk of it. Before Labour the hospital services represented 4.9%, whilst by 2010 it had grown to 21%, which is like 400% more. Yet, be careful and do not just blatantly accept my numbers either! My source (at http://sticerd.lse.ac.uk/dps/case/spcc/wp02.pdf) has a few issues, and there is a lack of clarity on reasons here. However, pharmaceutical services went down from 43.5 to 39.8 and even in 2010 to 31.8, which is good, but the history of generic pharmaceuticals is not clear in this regard, which is reliant on the ending of patents. Dental services has a fluctuation around 5%, so there does not seem to be a lot of options here. Yet, we must give clear admittance that there are elements that Labour could not foresee. The NHS costs went from 6.6% of GDP in 1997 to 9.6% in 2010, which happens when people grow old and do not die, they require treatment. The adjusted GDP was £279Bn in Q1 1997, £373Bn in Q4 2010, which means that the shift is a lot more than 3%, it is an additional £11Bn on top of the 3% shift. That shift in this ‘greying’ population will only get stronger. I am all for giving them the best care, they did their job. Which made me look at the drunk tank for those who have not done anything yet.

Yet, there is also other evidence. One part is found in the Public expenditure on health and care services (at http://www.publications.parliament.uk/pa/cm201213/cmselect/cmhealth/651/651.pdf). On page 35 we see “The evidence presented to the Committee demonstrates that the measures currently being used to respond to the Nicholson Challenge too often represent short-term fixes rather than the long-term transformations which the service needs“. I do not disagree with that statement, yet the commercial side remains an issue. Sir David Nicholson needed to cut 20 billion, or more. The Nicholson challenge was there to (attempt to) achieve this. When we see the political side whinge left, right and decently less from the centre, we need to accept that they are not paying the bills, when was there an agreement on both sides on how much the NHS was allowed to cost? Drastic cutbacks were the challenge and I am not stating that it was a great or the right solution, but it was close to the only solution. By the way, these cutbacks got started under the previous administration, headed by none other than Andy Burnham, so as he is stating issues with agency staff, I need to voice ‘howls of deriving laughter!’ it amounts to this blogger calling MP Andy Burnham a dunsel. You signed off on the need to cut back, you now do not get to steer the conversation in that manner Mr Burnham! The additional quote in his name is “Andy Burnham, the shadow health secretary, has further complicated the picture by suggesting a reformed NHS may need less than £8bn“, in what universe? After we dehydrate the drunks and drown the elderly? The mere increase in needed funds over the term 1997 – 2010 is an adjusted £11 billion that is just the increase, not including the required amount, which was already £18 billion in 1997. If I was a mean man I would point out to Mr Burnham that Excel does not treat the mean and the sum function in the same manner. So the sum over 4 years is not the same as the average per year per 4 year term. As stated, I am not a mean (not the same as average) person, so I will not say that to Andy Burnham MP for Liverpool. However, we need to be fair, Liverpool has its share of famous people, but perhaps no famous science people? In music there are the Beatles, in comedy there is John Bishop, there are actors, writers, but perhaps not any math people? Ah Darn, the famous John Horton, who came with the Combinatorial Game Theory (CGT) as well as revelations in Quantum mechanics. Mr Burnham, you should have known better!

Back to the NHS issue we go!

You see, it is in its most basic concept a simple equation BUDGET = SUM(COST1,COST2,,,COSTn); budget is known and for a while budget had to go down, which implies (using the word ‘means’ here might be confusing) that costs MUST go down. The biggest ones are usually location, maintenance and personnel. Location can usually not be tempered with, maintenance can be looked at, but with too much specialist equipment in NHS locations, there is not too much you can do and these devices usually come with a servicing fee that is not the cheapest one and with 20 devices you are usually looking at 15+ contracts. There are more devices and parts that fall under maintenance, yet there tends to be minimal movement here, so personnel remains. It is not fair, I completely agree, yet the list tends to be not that large and staff is usually the first cut (or not replaced). We all agree that it is short sighted, which The Health Committee agreed with. By the way, how many committees are there in the NHS and how much do those events cost? I’ll bet you that they are not playing for the cat’s violin, so there are costings there too. So as we see the following “As set out in the Health and Social Care Act 2012, each CCG must have a governing body. This body must have an audit committee and a remuneration committee“, now what will that part cost?

So you see, the list goes on and on. Some costings are a given, some are not and the needed funds increase every single year. In 10 years, the percentage increase over the GDP growth amounted to those eleven billions alone. We would like to do it better, more intelligent and cheaper, but how? If healthcare depends on high quality, there was never that much leeway to begin with. So are we left with the inhumane choices? I refuse to believe that, but to start to be less pampering to the binge drinkers seems in my humble opinion to be an acceptable first step.

I also believe that Jeremy Hunt is on track with the agency staff cuts, which is outrageous, but where to get the people then? I mentioned to him that he should consider opening the door to Australian medical graduates. Even though there is a rural shortage (no one wants to go there) the urban shortage is less true shortage. Perhaps Canada has that same option? What if these graduates work in the UK for a few year, for a decent income and an annual percentage payment to their study debt? It is usually easier to find graduates willing to be a little adventurous for a few years. It could work (at least lessen the pressures) and it will be a lot cheaper than £3,500 per doctor per shift, that will be an absolute given. If this solution works in getting the issues of the boil, the agencies will have no other option but to lower prices, their prices are linked to demand plain and simple. The NHS is literally experiencing the pounding the CIA got in 2003-2010, analysts went external as their income went up by 250%-400%, which was all the rage back there! So as the NHS HR literally knows how a CIA HR representative feels, we giggle a little more. But it is no laughing matter, analysts are 13 a dozen, Medical practitioners and nurses are an entirely different ball of wax and that equation is not easily solved.

So as the pressure of shortage remains, so will the existence of Dr Temp MD, it could even shift further into the temp direction, which spells bad times for the NHS. There is however one final part. In that Dr Mark Porter has a role to play too. The British Medical Association (BMA) is the trade union and professional body for doctors in the UK and has always ‘pushed’ for the highest standards, this was done to such an extent (before Porters time) that willing graduates from several nations were unable to get a VISA and rebuild their life in the UK, there is something to say for that ruling, but by keeping the ‘projected’ level of care so unobtainable high, the UK now faces a shortage issue. I think that these rules of immigration need to be looked at and additional solutions should be tapped into. I cannot guarantee that this will be THE solution, but it seems clear that not looking at this possibility will leave the NHS in the near death state it is now!

It is only one step, but any solution for the NHS should only be taken step by step, which is always better than no action at all.

 

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